Everything Providers wanted to
know about The Care Act 2014
but were afraid to ask…
www.oacp.org.uk
@OxonACP
“Local authorities must not undertake any
actions which may threaten the
sustainability of the market as a
whole…for example, by setting fee levels
below an amount which is not sustainable
for providers in the long term.”
Care and Support Statutory Guidance,
June 2014
www.oacp.org.uk
@OxonACP
Legislative base change, including…
1.
National Assistance Act 1948
2.
Chronically Sick and Disabled Persons Act 1970
3.
NHS and Community Care Act 1990
4.
Choice of Accommodation Directions 1992
5.
Delayed Discharges Regulations 2003
6.
NHS Continuing Healthcare (Responsibilities) Directions 2009
7.
Charging for residential accommodation guidance (CRAG) 2014
8.
Transforming Adult Social Care (LAC(2009)1)
9.
Fair Access to Care Services (FACS) guidance on eligibility criteria
10. No secrets: guidance to protect vulnerable adults from abuse
www.oacp.org.uk
@OxonACP
The Care Act introduction
Part 1 – April 2015
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Wellbeing and safeguarding
Eligibility
Carers’ rights to assessment
Prevention, advocacy, market shaping
Deferred payments
Partnership working
Part 2 – April 2016
– Care Account
– Care Cap
– Increased funding thresholds
www.oacp.org.uk
@OxonACP
The Care Act: a new statutory base
1. Care Act 2014
2. A range of regulations
3. Statutory Guidance
In practice, much will remain the same for
providers, with new opportunities
Q. How does your organisation respond to
change?
www.oacp.org.uk
@OxonACP
Rebalancing of social care focus
• Now, LA duty is to provide particular services
• From April 2015, LA to ‘meet needs’ – Care Act is person
centred
• LA must act to promote wellbeing
• Emphasis on integration and co-operation between
agencies
• Prevention and delaying need
Q. How much do you already work in partnership?
www.oacp.org.uk
@OxonACP
Changes: Principle of wellbeing
Wellbeing includes:
1. personal dignity (including treatment of the individual with
respect)
2. physical and mental health, and emotional wellbeing
3. protection from abuse and neglect
4. control by the individual over day-to-day life (including over care
and support provided and the way it is provided)
5. participation in work, education, training or recreation
6. social and economic wellbeing
7. domestic, family and personal
8. suitability of living accommodation
9. the individual’s contribution to society
Q. What services could you provide that promote wellbeing?
www.oacp.org.uk
@OxonACP
Changes: Assessment, including carers
• Equivalent rights for carers, as for those they care for,
including:
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Wellbeing principle
Preventing needs for support
Right to assessment where there are needs for support
Eligibility: national minimum threshold for carers
Planning: rights to personal budgets, direct payment, support
plan
– Market shaping must ensure appropriate services for carers
• Understand how the process works, be able to explain it to
people seeking care and support, and guide them to their LA
Q. Are you ready to offer services to carers?
www.oacp.org.uk
@OxonACP
Changes: National eligibility criteria
• Understand the criteria based on:
– whether a person’s needs are due to a physical or mental impairment or
illness
– to what extent a person’s needs affect their ability to achieve two or
more specified outcomes
– whether and to what extent these have a significant impact on their
wellbeing.
• Understand 10 outcomes when eligibility is determined
• Formal appeal process from 2016
Q. Are your services outcome-focused?
www.oacp.org.uk
@OxonACP
Changes: Care planning and review
Identify outcomes within the care and planning process that
will establish the cornerstone of a subsequent care plan
• Everyone will have a costed personal budget as part of
their care and support plan
• People can choose whether to receive their personal
budget as a direct payment
• Plans must pertinent and intelligible to the person: role of
advocacy?
• Services may be delivered through ‘non-care’
Q. Are you ready to respond to micro-commissioning?
www.oacp.org.uk
@OxonACP
Changes: Deferred payments
Review commercial terms to be able to explain to clients
and potential clients how to access deferred payment of
core care costs in line with LA policy
• No selling of home within lifetime, but interest and admin
fee chargeable
• Enduring / Lasting Power of Attorney for those without
capacity
Q. Do you have existing channels for informing
potential clients?
www.oacp.org.uk
@OxonACP
Changes: Funding reforms
• As before, intermediate care for up to 6 weeks and minor aids to
value of £1,000 arranged by LA must be free of charge to the service
user. LA must consider if continuation beyond 6 weeks will reduce
hospital admission.
• Top-up fee arrangements to be done through LA
• Self-funder re-charge to be extended to Care Homes from April 2016
to match Dom Care arrangements
• LA may charge admin fee for self-funders
• April 2016: biggest funding reforms for 60 years to provide protection
from spiralling costs
Q. Are you clear, & can you articulate, what prevention means?
www.oacp.org.uk
@OxonACP
New areas: Market shaping and
commissioning
Understand LA powers and duties when a care
provider fails or provision of a service is interrupted.
• Providers can achieve delivery of high quality well
resourced care and support through fair employee
contracts and adequate remuneration
• LA must not set fees below an amount not
sustainable for providers in the long-term
Q. Does the LA demonstrate an understanding of
your business or sector challenges?
www.oacp.org.uk
@OxonACP
New areas: Provider failure and service
interruptions
• LA must ensure needs are met where a
provider fails and this impacts on a
person’s wellbeing
• Applies to CQC and non-CQC registered
providers
Q. How resilient is your business?
www.oacp.org.uk
@OxonACP
New areas: Market oversight
• CQC will have new function to oversee financial sustainability
of providers that would be difficult to replace were they to fail.
• Applies to largest and difficult to replace providers, i.e.:
– Dom Care providers who deliver 30,000 hours or more care in a
week, or deliver care to 2,000 or more people in a week, or
deliver care to 800 or more people in a week and they each
receive more than 30 hours in that week.
– Residential care providers with bed capacity of 2,000 beds or
more, or bed capacity of between 1,000 and 2,000 beds and
either they have beds in more than 16 LA areas, or the capacity
in each of three or more LA areas exceeds 10% of the bed
capacity of those local authorities.
• Providers have duty to provide information to CQC. Applies to
smaller/ specialist providers
Q. Does this apply to you; size, capacity, specialism?
www.oacp.org.uk
@OxonACP
New areas: Statutory safeguarding
• Be aware of the need for adult safeguarding policies and procedures
and the areas to cover; benchmark against existing policies and
procedures and draw up new ones where required. Access
Safeguarding Boards annual reports
• 6 key safeguarding principles – a partnership approach to delivering
outcomes
• LA has role is engaging public to reduce social and physical isolation
/ abuse and neglect
• Providers must promote wellbeing in person-centred safeguarding
• Statutory footing for SAB
• Provider policies and processes must reflect 9 areas in statutory
guidance
Q. What does safe mean, and how do you balance this with
wellbeing?
www.oacp.org.uk
@OxonACP
New areas: Information, Advice and
Guidance
• Have in place information about services
provided so that individuals can decide if those
services are appropriate for them.
• LA should make effective use of a range of
outlets: statutory, voluntary, private sectors;
variety of sources
Q. Is your information appropriate for potential
clients?
www.oacp.org.uk
@OxonACP
New areas: Duty of Candour
• Understand provider responsibility to be open
when things go wrong and actions they are
expected to take
• Specific and detailed responsibility on all
provider
• Open to legal enforcement by CQC
Q. How up to date and is your whistle-blowing
policy?
www.oacp.org.uk
@OxonACP
Opportunities: Prevention
• Consider what preventative services are currently offered and
what could be delivered in the future.
• LA responsibilities for prevention apply to all adults, including:
– People who do not have any current needs for care and support,
– Adults with needs for care and support whether their needs are
eligible or not,
– Carers
– Prevent: primary prevention – promoting wellbeing
– Reduce: secondary prevention – early intervention
– Delay: tertiary prevention
Q. Are you innovative and do you understand emerging
needs?
www.oacp.org.uk
@OxonACP
Opportunities: Independent Advocacy
• LA must arrange independent advocacy for those who
experience substantial difficulty in arranging their care (& if
there is no appropriate person)
1.
2.
3.
4.
understanding relevant information
retaining information
using or weighing up the information
communicating views, wishes and feelings
• Care Act: advocacy focuses on involvement in care and
support process
• Consider offering this service to local authorities in future
Q. How many people would have substantial difficulty if they
have no appropriate person?
www.oacp.org.uk
@OxonACP
Opportunities: Personal budgets / direct
payments
• Providers should review their commercial terms
to enable people using their services to use
personal budgets and direct payments.
Q. Do you have clear guidance for potential
clients wishing to spend their personal budget
with you?
www.oacp.org.uk
@OxonACP
Opportunities: Integration, co-operation
and partnerships
• Provider to consider what services it might
offer now and in the future as a result of
integration
Q. What services could you provide that
underpin well-being?
www.oacp.org.uk
@OxonACP
Opportunities: Transition from children’s
to adults’ services
• Understand local authorities’ duty to conduct a
transition assessment.
• Assessment planning around individual needs.
Q. Do you have practical arrangements with
children’s services for young adults to
transition easily?
www.oacp.org.uk
@OxonACP
Opportunities: Ordinary residence
• Understand geographically which LA is
responsible for each service user.
• Develop expertise to assist LA in discharging
their functions of determining best interests.
Q. If you have regional / national connections,
are you ready to support people moving from
one service to another?
www.oacp.org.uk
@OxonACP
Opportunities: Delegation of functions
• Providers should consider what existing services
they might want to offer, and any new services
they might wish to develop, that may fit with
functions delegated by local authorities.
Q. Are you a provider, or a provider+?
www.oacp.org.uk
@OxonACP
More information
http://www.local.gov.uk/documents/10180/6869714/L14759+Guide+to+the+Care+Act.pdf/d6f0e84c-1a58-4eafac34-a730f743818d
Q. What other support do you need?
www.oacp.org.uk
@OxonACP